Digital addiction: Is it real or a symptom of other problems?

August 20, 2013
by Rick Montgomery, The Kansas City Star

The morning's topic glowed on a big screen: "Social Media Burn-out." Strange, but the 70 hash-tag junkies who attended the August breakfast for Kansas City's Social Media Club appeared mostly fit and happy. Joking, checking their phones, tweeting here and there, munching fruit and whole-grain bagels.

They didn't look sick.

Yet consider the terminology many therapists and researchers use to describe our tight embrace of new technologies: Internet addiction. Or IA, for short. Mental health experts debate the breadth and meaning of the term - if such a malady even exists.

Some contend that excessive computer time leads to insufficient outdoor time, or "nature deficit disorder." The worst sufferers, perhaps, could benefit from digital detox, a getaway from the gadgets that can hook us.

The American Psychiatric Association recently recommended further research into a condition it labeled Internet Gaming Disorder. In the latest version of the APA's diagnostic manual released in May, the group pointed to warning signs in Asia, where too much gaming has landed kids in hospitals.

Can online, all the time, really make you ill?

Try Googling "cyberpsychology." The verdict is split.

One speaker at the burnout breakfast - Brooke Beason, who specializes in social media for an ad agency - recalled the withdrawal symptoms she experienced when giving up Facebook for Lent.

For "40 days and 40 nights," Beason said, she fought the impulse to reach for her phone and post at all hours. "There were a couple of occurrences where I could feel my blood pressure rise," she told the crowd. But over time she felt a greater sense of self-control.

Ramsey Mohsen spoke next.

Director of social media at the digital marketing group DEG in Overland Park, Kan., Mohsen challenged the thinking that a well-wired geek must, on occasion, go cold turkey. His advice: Stay connected, but do not become a servant to gadgetry.

"You control the technology - not the other way around," he insisted.

Mohsen admitted being as tech-obsessed as anyone. He spoke, after all, with the new Google Glass device wrapped around his skull.

Next month, the Internet Addiction Treatment and Recovery Center will open to inpatients at Pennsylvania's Bradford Regional Medical Center.

The center's director, psychologist Kimberly S. Young, said the four-bed hospital unit will be the nation's first to provide medically based detoxification for electronics addicts.

Programs to unplug people from all things digital are in vogue.

The scenic Digital Detox retreat in California offers "four days of serenity and bliss" without devices, enabling the brain "to once again think in truly novel and surprising ways." (So says the retreat's website.)

What Young and Bradford Regional have in mind, however, is a clinical intervention - to rescue gadget addicts whose sleepless lives are crumbling. "We're not horseback riding," Young said.

The treatment plan: Keep patients for 10 days. Medicate, if needed, to stabilize them. After 72 tech-free hours, carefully integrate devices back into their world - because after their release, smartphones, laptops and game consoles will still be out there, seducing them.

Through counseling, the recovery center staff will identify underlying issues - relationship problems, for example - that cause some people to escape to the joystick or keypad.

Whether or not anyone will seek treatment is an open question.

"If Internet addiction is a problem," said Young, who is convinced the disease is real, "you'll see patients."

Parents of game-obsessed youth with poor grades already have expressed interest. But because the American Psychiatric Association does not deem Internet addiction an official diagnosis, health insurers aren't likely to cover treatment, Young said.

Studies estimate that 4 to 10 percent of Americans struggle with keeping computer use in check. Some surveys suggest an even bigger problem for young adults: One New York university found that nearly half of its freshmen dropouts frequently had stayed up all night on the Internet while enrolled.

Young was among the first researchers to explore the mysterious lures of the information superhighway, beginning in 1994.

"When the Web got started, (the addictions) were chat rooms and pornography," Young said. "In the late '90s, it was day trading. Then it was gambling, social media and online gaming."

The mental health community is far from sold that the Web itself is fueling addiction. Gambling and pornography were claiming addicts long before the dot-com days.

And as for obsessions that require the Web - round-the-clock Twitter checks, online World of Warcraft marathons - many psychiatrists question the harm.

"To use a label - a term like addiction - nobody wants to do that lightly," said Chester Day, chief psychiatrist at the Wyandot Center for Community Behavioral Healthcare in Kansas City, Kan. "Nobody wants to be presumed ill just pursuing a passion."

When considering which illnesses to include in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders - the bible of the psychiatric profession - the association balked at listing Internet Gaming Disorder as a disease, but did endorse further study.

Proposals to include broader ailments such as "Internet addiction" or "pathological computer use" were rejected by the DSM-5 review board.

"I don't believe that the DSM-5 has settled the controversy over what I have called pathological use of electronic media," or PUEM, said Ronald Pies, professor of psychiatry at State Universities of New York and the Tufts University School of Medicine.

"We have a lot of case reports and anecdotes, but not many carefully done studies that examine the underlying causes of PUEM," he said. "If a very socially anxious, somewhat depressed teenager spends 12 hours a day on the Internet, does this represent an addiction to the Internet?

"Or is it really an expression of his intense awkwardness and anxiety about dealing face to face with people?"

Holly Hemphill, a marriage and family therapist in Liberty, says she sees computer issues flare in 80 percent of the couples she counsels.

"It's a huge problem," she said. "When men are spending too much time on the computer, it's usually gaming. For women, it's Facebook. ... Sometimes, social media or computer games become a third party in the relationship, almost another person that partners feel they're competing with."

Hemphill knows couples who resort to locking up devices to prevent Web access; each spouse keeps the access code for the other's smartphone.

Still, is it fair to blame the gadgets - or even an addiction to the gadgets - when couples can't get along?

Some studies suggest technology truly is the culprit, because those gadgets may be affecting our brains.

In China, scientists in 2011 analyzed the brains of college students considered to be computer addicts, those who were online at least 10 hours a day. Parts of the students' prefrontal cortex and cerebellum were smaller than similar areas in a control group deemed not addicted.

Skeptics countered that the study could not establish that computer overuse caused the reduced brain areas; maybe the brain shapes determined how efficiently people accessed the Internet.

A plethora of brain imaging research shows that areas associated with drug addiction light up during computer use. Online gaming, in particular, will trigger the release of dopamine, the chemical that gives us pleasure.

The good news: A Stanford University study found that more than 90 percent of people who reported a desire to spend less time online were successful.

The benefits of unplugging, if only for a few days, include "startling cognitive improvement" and "an almost 50 percent increase in creativity," according to a report issued last year by the University of Kansas.

KU psychologist Ruth Ann Atchley led a team on a backpacking trip in Utah to gauge the creative intelligence gained from experiencing nature.

Using the Remote Associates Test, a word-association exercise long used by psychologists, Atchley found that creativity scores spiked in the wild.

The test was then given to 120 participants on outings to Alaska, Colorado and California. Similar improvements were charted.

"We think that (creative intelligence) peaks after about three days of really getting away, turning off the cellphone, not hauling the iPad, and not looking for Internet coverage," Atchley said.

Gene Willis surrendered all social media for Lent. As a marketing director for a digital publisher in Kansas City, he knew giving up his networks at home would be a challenge.

"Absolutely, I had an itch" to check the Twitter, Facebook, GetGlue and FourSquare apps on his phone every morning in bed, Willis said.

Text-free living changed Willis more than he expected.

"At times, when I'd be more apt to go to my phone just out of boredom, I'd turn and talk to someone," he said. "I took note of the simple things around me."

There are moments to disconnect even for the ultra-wired Mohsen, who wore Google Glass at the burnout breakfast.

In June, he surprised his girlfriend with a marriage proposal. How cool would it have been to capture her reaction in high definition, looking straight into Mohsen's eyes?

Nah. He set Google Glass aside. And when she accepted his proposal, the couple kept the news to themselves.

"We were going to make that our night," Mohsen said, "and not trust anything to social media."

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